NPIMap

Organization Active NPI

Brett Cutler DPM PA

  • Podiatrist
  • St Augustine, FL
National Provider Identifier
1194927640
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO 2940 Issued in FL
Legal business name
BRETT CUTLER DPM PA
Practice address
105 Southpark Blvd
Suite A103
St Augustine, FL 32086-4162
Phone
(904) 824-0869
Fax
(904) 826-0966
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Brett Cutler, D.P.M.NPI 1710987805
Title
President
Phone
(904) 824-0869

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PO 2940 FL Primary

Addresses

Primary practice location

105 Southpark Blvd
Suite A103
St Augustine, FL 32086-4162

Mailing address

105 Southpark Blvd
Suite A103
St Augustine, FL 32086-4162
Phone (904) 824-0869

Other identifiers 3

IdentifierTypeStateIssuer
21590OtherFLBLUE SHIELD
340202900MedicaidFL
4298427OtherFLAETNA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1194927640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD",
            "address_2": "SUITE A103",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864162",
            "telephone_number": "904-824-0869",
            "fax_number": "904-826-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD",
            "address_2": "SUITE A103",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864162",
            "telephone_number": "904-824-0869",
            "fax_number": "904-826-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT CUTLER DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "CUTLER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-824-0869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO 2940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "21590",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340202900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4298427",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.